Changing indications for penetrating keratoplasty: histopathology of 1,250 corneal buttons

Cornea. 1998 Sep;17(5):468-70. doi: 10.1097/00003226-199809000-00002.


Purpose: To analyze recent trends in the indications for penetrating keratoplasty.

Methods: After keratoplasty, 2,557 corneal buttons were sent to and analyzed in the ophthalmopathology laboratory of the University of Erlangen-Nürnberg, Erlangen, Germany, between 1992 and 1996. Of these, 1,250 random corneal buttons were evaluated in this study.

Results: Histopathologic diagnoses were (a) keratoconus (20.9%), (b) corneal scarring after keratitis/trauma (20.4%), (c) pseudophakic/aphakic bullous keratopathy (17%), (d) regraft (15.5%), (e) Fuchs' corneal endothelial dystrophy (14.9%), (f) necrotizing/ulcerative keratitis (5.3%), and (g) corneal dystrophies (1.7%).

Conclusion: Compared with a previous report from our laboratory (1964-1986), the relative frequencies of pseudophakic/aphakic bullous keratopathy, regraft, and Fuchs' dystrophy increased, whereas corneal scarring decreased. Keratoconus is now the most frequent indication for penetrating keratoplasty.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Cornea / pathology
  • Cornea / surgery*
  • Corneal Diseases / diagnosis
  • Corneal Diseases / surgery*
  • Female
  • Humans
  • Infant
  • Keratoplasty, Penetrating / trends*
  • Male
  • Middle Aged